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Risk-Based Mammo Screening, SABCS News, and New QA Standard
December 14, 2025
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Together with
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“The next stage of AI maturity isn’t about better algorithms; it’s about better deployment, integration, and financing and making the technology accessible, sticky, and ROI-positive for practices.”
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Anand Prabhakar, MD, chair of radiology at MGB’s Newton-Wellesley Hospital.
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Radiology stands at a breaking point. Hospitals and imaging practices are overwhelmed by fragmented IT systems, cumbersome technology integrations, and staff burnout. Medical imaging is the central hub through which more than 80% of healthcare data flows, but it’s become hobbled by technology that was never designed to work together. Learn how Sirona Medical is changing the equation by rebuilding radiology software from the ground up with a cloud-based architecture that’s as simple as launching a web browser.
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Is mammography screening based on patient risk ready to take over for age-based screening? Results from the WISDOM study presented at last week’s San Antonio Breast Cancer Symposium and published simultaneously in JAMA suggest that while risk-based screening has its merits, more work may need to be done.
Cancer screening exams like mammography have reduced disease-specific mortality, but (with the exception of lung cancer screening) all use exclusively age-based criteria to determine who should get screened.
- Age isn’t a great tool for determining who’s at higher risk of getting cancer, but it’s the best tool we’ve had – up to now.
New cancer risk prediction tools are now becoming available, prompting debate over whether these techniques could make screening more precise by directing it to those most at risk.
- Higher-risk people could get more frequent screening, while lower-risk individuals might be directed to longer screening intervals.
The WISDOM study presented at SABCS 2025 investigates this question. WISDOM is a randomized clinical trial that compared risk-based breast screening to age-based annual screening in 28.4k women followed for five years.
- Risk categorization was performed with genetic testing, polygenic risk scores, and BCSC scores, which incorporate family history and imaging results.
Women in the risk-based screening group were directed into one of four screening strategies, from alternating mammography and MRI every six months for high-risk women to no screening until age 50 for low-risk women.
- The study’s primary outcomes were detection rates for breast cancers rated as stage IIB or higher and effectiveness in reducing biopsy rates – a proxy for screening-caused morbidity.
Across the study population, researchers found…
- The rate of mammograms per 100k person-years was lower in the risk-based cohort compared to age-based screening (43.1k vs. 46.9k).
- The rate of stage IIB or higher cancers per 100k person-years was also lower in the risk-based cohort (30 vs. 48).
- But there was no statistically significant difference in biopsy rates, with a rate difference of 99 per 100k person-years (p = 0.10).
One problem with the WISDOM trial was that the actual screening exams were performed outside the study, and some patients did not comply with screening recommendations, potentially confounding results.
The Takeaway
The WISDOM authors concluded that a risk-based screening approach is safe, but the lack of a difference in biopsy rates makes one wonder if veering from established age-based criteria is worth it. In any event, the coming arrival of risk stratification based on AI mammogram analysis could make the genetic testing-based approach used in WISDOM obsolete.
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Opportunistic Detection of CAC and Pulmonary Nodules
Achieve a newfound certainty of search for thoracic CT when using ClearRead CT from Riverain Technologies. It’s a natural addition for opportunistic CAC scoring and nodule detection, or as part of a CT lung cancer screening program.
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Cut Repetitive Manual Tasks
Discover how Rad AI’s radiology reporting software helps you speak less and say more by reducing dictation times up to 50% and words dictated up to 90%. Join 9 of the top 10 radiology practices using Rad AI to improve efficiency.
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Taking Flight at RSNA 2025
What were RSNA 2025 highlights at Mach7 Technologies? Watch this video to learn how the company debuted new customer engagement initiatives like the Flight Crew, as well their new Flamingo Architecture, to help customers achieve success.
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- Breast MRI Not Needed in Some Patients: In another study from SABCS 2025, preoperative breast MRI to find additional cancers that mammography missed could be omitted in low-risk patients who are already scheduled for surgery. In a group of 319 patients followed for five years, there was no statistically significant difference in locoregional cancer-free rates between those who got preoperative MRI and those who didn’t (93% vs. 96%), nor were there differences in distant recurrence-free survival (94% for both) or overall survival (93% vs. 91%).
- PET/CT Predicts Treatment Response: PET/CT could be an accurate way to assess treatment response in patients with HR+ breast cancer that’s spread to the bone – the most common site of breast cancer metastases. In results from the FEATURE trial presented at SABCS 2025, FDG-PET/CT scans were performed on 138 patients at 12 weeks from the start of systemic therapy. If patients showed no signs of disease progression, they had an 83% lower hazard of their cancer worsening.
- HAP Lands Indiana Group: Healthcare Administrative Partners landed a contract to provide its revenue cycle management services to radiology group Summit Radiology of Fort Wayne, Indiana. Summit provides image interpretation services to over 40 hospitals and outpatient sites in the state, and HAP will perform all core revenue cycle services including billing, coding, carrier credentialing, business intelligence, and MIPS assurance services.
- One QA Standard to Rule Them All: The ACR released a new standard for assessing image quality across all its programs: the Medical Image Quality Assessment System. MIQAS is described in a new paper in JACR in which image quality is graded on a five-point scale of 0 to 4, with 0 categorized as “out of standard” and 4 rated as “excellent.” Authors note there is no globally accepted standard for image quality, leaving independent groups and vendors to develop standards with varying definitions.
- MedPAC Mulls Payment Changes: The Medicare Payment Advisory Commission met earlier this month to discuss its reimbursement recommendations to Medicare for 2027. An ACR analysis indicates MedPAC’s draft recommendation calls for increasing payments rates by 0.5 percentage points more than current law. MedPAC also debated a proposal for site-neutral payment rates that base payments on care delivery rather than site location in an attempt to reduce incentives for provider consolidation, such as hospitals acquiring outpatient care facilities.
- MRI of Cardiac Fat Predicts Risk: In another study supporting the value of imaging-based biomarkers, cardiac MRI measurements of epicardial adipose tissue around the heart predicted cardiac injury after myocardial infarction. Researchers at EACVI 2025 presented data on 1.2k patients who got cardiac MRI scans within 10 days after a percutaneous coronary intervention following a heart attack. Higher EAT volume was associated with greater infarct size and larger area at risk, but lower microvascular obstruction. Cardiac MRI could aid cardiovascular risk assessment after infarctions.
- Chest X-Ray AI Helps Junior Radiologists: A chest X-ray AI algorithm helped junior radiologists achieve performance levels close to more experienced readers in a new study in Clinical Imaging. Researchers in Taiwan used the QOCA AI algorithm from Taiwanese electronics company Quanta Computer to analyze 400 chest radiographs. They found that junior residents saw the biggest performance gains in areas like AUC and specificity for pulmonary nodules (+12% and +23%, respectively) and pleural effusion (+7.6% and +11%, respectively), showing that AI can standardize the performance of different readers.
- 4DMedical Gets New Customers: 4DMedical signed a pair of new customer contracts for its lung function analysis technology. The University of Miami in Florida has begun clinical use of the company’s CT:VQ technology for ventilation/perfusion studies, while Lahey Hospital & Medical Center in Massachusetts will deploy the firm’s Lung Density Analysis and IQ-UIP solutions on an annual subscription model that covers up to 24k scans a year.
- Lumexa Imaging IPO Raises $463M: Outpatient imaging center operator Lumexa Imaging completed its IPO last week, with the company’s stock trading on the Nasdaq exchange under the symbol LMRI as CEO Caitlin Zulla rang the exchange’s opening bell on December 11. Lumexa priced the IPO at $18.50, and by the end of the first day of trading it stood at $18.52, up slightly. The company raised a total of $463M.
- Positrigo Scores U.S. PET Sale: Swiss dedicated brain PET developer Positrigo scored a contract to install its NeuroLF scanner at The Neuron Clinic, a Southern California neurology practice with six locations. It’s the first NeuroLF installation at an independent U.S. neurology practice for Positrigo, which earlier this year raised $8.5M to commercialize the system in the U.S. and Europe. Positrigo is positioning NeuroLF as a more economical alternative to whole-body PET scanners for diagnosing neurological disease.
- Service Firms Combine: Medical equipment sales and service provider Brown’s Medical Imaging completed its merger with Prestige Medical Imaging, with the combined company continuing operations under the Brown’s branding. The combined company has over 150 field-based service engineers and provides multi-vendor service across the U.S.
- Nexus Rebrands as NXXIM: German imaging informatics software company Nexus Enterprise Imaging rebranded as NXXIM and secured private equity funding with the goal of bringing an AI-powered enterprise image management platform to market in 2026. NXXIM received an investment from Geneva Private Equity of New York City and is building a leadership team to commercialize the platform, which combines multimodal AI with workflow orchestration.
- U.K. Pushes Back on Mammo Screening Petition: The U.K. government is pushing back against a petition to lower the breast screening age in the country to 40. U.K. guidelines call for screening women ages 50-70 every three years in the NHS Breast Screening Programme, but a recently filed petition seeks to start screening at 40, citing higher breast cancer incidence in younger women. However, an official notice on Parliament’s website stated the government does not intend to lower the age or increase the frequency of screening.
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Interpretation Efficiency in Radiology – A Critical Strategy
Healthcare institutions are at a critical stage, where an emphasis on interpretation efficiency needs to be a priority. Download this white paper from Visage Imaging and Signify Research on strategies to optimize your interpretation efficiency.
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A New Era of Imaging Technology
MosaicOS is the cloud-native and AI-native operating system from Mosaic Clinical Technologies designed to expand capacity, cut reporting time, and deliver faster, smarter patient care. Discover how it can improve your radiology operations today.
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- Every Image Tells a Story: Intelerad’s enterprise image management solutions are empowering radiologists and patients while transforming radiology workflows. Learn about the technologies they highlighted at RSNA 2025 for empowering imaging professionals.
- Optimize Radiology Workflows: Harness cloud and AI technology to help your radiology teams unlock insights, increase efficiencies, and improve patient care. Learn more about an integrated approach to AI in radiology in this e-book from Microsoft.
- Connected Imaging. Empowered Flow: Know those rare and indescribable moments at work when distractions melt away? AGFA HealthCare’s Enterprise Imaging Platform is designed to keep you in that hyper-focused state of mind all day long. Learn more about their solutions today.
- Solving Burnout through Teleradiology: Is your radiology staff facing burnout? Check out this case study to find out how Northern Light Medical Management addressed burnout with teleradiology solutions from Merge.
- Echo AI for Cardiac Amyloidosis: AI is reshaping the way cardiac amyloidosis is detected. A notable example is Us2.ai’s pattern recognition model, which can identify the disease from a single apical four‑chamber echo view.
- Elevating Breast Cancer Detection: Breast Suite from DeepHealth is a new package of AI-powered solutions delivering increased breast cancer detection rates, risk stratification tools, and viewing and reporting workflow acceleration. Find out how it can benefit your practice today.
- Bring Your Radiology AI into Your Clinical Workflows: CARPL enables healthcare providers and researchers to develop, test, and deploy their own AI models within existing clinical infrastructure. From seamless data ingestion and de-identification to model training, packaging, and live deployment, CARPL provides an end-to-end environment tailored for radiology.
- A Next-Generation Oncology Ecosystem: Quibim launched their next-generation oncology ecosystem platform at RSNA 2025. Find out how QP-Prostate provides a comprehensive, end-to-end management workflow for prostate cancer care, supporting clinicians from the earliest stages of image acquisition through diagnosis, patient management, and follow-up.
- Discover the Difference in Fluoroscopy: Whether tableside or universal remote, fluoroscopy systems impact safety, workflow, and patient care. Discover the difference LUMINOS Q.namix R and T from Siemens Healthineers make in the industry.
- Learn a New Subspecialty in 5 Minutes a Day: Become a faster, more confident radiologist with expert-led online video courses from Medality. Gain simulated practice with the largest collection of curated, scrollable DICOM cases available anywhere. Browse their library of radiology courses today.
- It’s Time to Make AI Adoption Simple: Gleamer unifies a fragmented AI landscape into a single, simple, powerful platform. Discover an AI ecosystem where everything is designed to be intuitive, consistent, and scalable, making AI adoption simpler than ever.
- Discover the Story of Philips BlueSeal: When Philips designed their BlueSeal MRI, they had our planet in mind, considering energy efficiency. This led to potential energy savings of 40 megawatt-hours per year. Thanks to BlueSeal’s fully sealed magnet design, there is zero helium loss during the system’s lifetime.
- A Passion for Change: United Imaging’s passion for change was on display at RSNA 2025 with the launch of new products across multiple modalities, including the new uSonique ultrasound family shown as works-in-progress. Find out what drives the company on this page.
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